Research suggests that providing substance use disorder (SUD) services in health care settings is feasible, can reach many more individuals than reliance on community-based specialty SUD treatment alone, promises better outcomes for patients, and can result in reduced overall health care utilization costs.Furthermore, as a result of the Affordable Care Act, mental health and SUD treatment are expected to become more closely integrated with each other and with primary care. However, little data on the current state of integration currently exists. We conducted a small study targeting federally qualified health centers (FQHCs) using online surveys and qualitative interviews to assess SUD integration with primary care, mental health, and HIV/AIDS services in California primary care settings. Results: Half of the organizations reported collaboration between SUD and primary care, but the other half reported only minimal or basic levels of integration. In general, SUD services are not as well integrated with primary care as mental health services are, are rated as less effective than mental health services, and are separated from primary care services physically and temporally. The difference in effectiveness appears to be due to provider training, not in attitudes toward SUD patients. Participants indicated interest in obtaining training in SUD treatment to address this. Policy recommendations were included in the final report.

Integration of Substance Use Disorder Treatment with Primary Care in Preparation for Health Care Reform was funded by California Program on Access to Care, contract KKN06A, from October 2011 to October 2012.